BIRTHS to mothers aged over 45 have grown faster in Scotland than anywhere else in the UK over the past 15 years, it has emerged, as the leader of Scotland's midwives warned that there are signs the country's maternity service is "beginning to buckle".
The number of babies born to women over 45 in Scotland increased five-fold, from 29 in 2000 to 143 in 2015, amid the trend for older pregnancies and increased availability of fertility treatments both privately and on the NHS. The age group now accounts for three in every 1000 live births north of the Border compared to around one per 1000 births in England and one per 2000 births in Wales.
The 393 per cent rise in Scotland also outstrips the 228 per cent increase in England and Wales over the same period, from 663 babies to mothers aged 45 and over in 2000 to 2,175 in 2015.
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In Northern Ireland, the increase was 281 per cent, from 16 to 61 live births.
Scotland has led the way on NHS access to fertility treatment, with couples where the woman is aged up to 42 currently entitled to two rounds of IVF on the health service, with this set to increase to three rounds. In England and Wales, the cut-off is 40. The Scottish Government also plans to extend the treatment to couples who have children from a previous relationship.
Mary Ross-Davie, director of the Royal College of Midwives Scotland, said the figures may signal Scotland "catching up" on the shift towards older pregnancies.
She said: "Traditionally in Scotland, the age at which women had babies was younger than down south. So there is a sense that we are behind that demographic trend [for older mothers] and now just catching up."
It comes as a report by the Royal College of Midwives warned that the "added complexity and cost" of older pregnancies "means that more needs to be invested in maternity care" to ensure the NHS can cope.
Pregnancies among over-45s carry a higher risk of miscarriage, difficult labours and multi-morbidities in the mother, such as diabetes or high blood pressure. They are also more likely to end in caesarean deliveries.
Meanwhile, maternity services are also under strain from obesity, with 22 per cent of expectant mothers in Scotland now obese.
Ms Ross-Davie added: "With older mothers it is the women of course who will decide when they get pregnant, and we support whatever choices they make. What is important is that we have the right numbers of staff and resources to give all of these women the best possible care.
"Scotland’s maternity services are very good but there are signs that it is beginning to buckle as demand rises."
However, Professor Alan Cameron, a Glasgow-based consultant obstetrician and former vice-president of the Royal College of Obstetricians and Genealogists, said the surge in births among over-45s should not be a major worry.
He said: "The numbers are so diluted at a board level that I don't think it poses a major resource problem. From a baby point of view there are increased risks, but many of them will be IVF and donor eggs so the risk to the baby is less because the egg donor will be younger than the woman giving birth."
The RCM report also warns that midwifery training in Scotland must plug a looming retirement exodus, with 41 per cent of staff currently over-50.
While the report noted the "very welcome" recovery in student midwife numbers to a five-year high, it said: "Failure to get to grips with this problem could wipe out the success Scotland has had in recent years, especially when compared to England, in maintaining an appropriately sized midwifery workforce."
Health Secretary Shona Robison said: "The College’s report recognises that the Government has consistently increased student midwife numbers over the last few years and acknowledges that Scotland has continued to maintain an appropriate sized workforce when compared to other parts of the UK.
"However we recognise that challenges still remain and will continue to work with the College to shape our student midwife numbers and the future direction of midwifery policy in Scotland."